北京永定路社区老年2型糖尿病患者血糖、血脂、血压联合达标动态观察研究  

Dynamic Observation of Joint Control Rate of Blood Glucose,Lipid and Pressure for Elderly Patients with Type 2 Diabetes in Community

作　　者：李月[1] 沈冬云 张伟[3] 王毅敏 李红梅[5] 耿杰[1] 杨丽英[1] 李红梅[1] 肖志军[1] 刘焱 冯志刚[6] 曹林英 金岩[4] 王璇 

机构地区：[1]北京市航天中心医院社区卫生服务中心,100049 [2]北京市六街坊社区卫生服务站 [3]北京市航天中心医院四街坊社区卫生服务站 [4]北京市八街坊社区卫生服务站 [5]北京市九街坊社区卫生服务站 [6]北京市翠微西里社区卫生服务站

出　　处：《中国全科医学》2013年第25期2969-2971,2975,共4页Chinese General Practice

基　　金：首都医学发展科研基金(2007-1035)

摘　　要：目的了解北京市永定路社区60岁以上2型糖尿病患者血糖、血脂、血压联合达标情况。方法以永定路社区192名60岁以上已诊断2型糖尿病患者为研究对象,进行规范化管理,观察30个月血糖、血脂、血压动态变化。结果观察期末餐后2 h血糖、三酰甘油(TG)、舒张压(DBP)达标率(76.37%、70.06%、78.02%)较入组时(56.28%、54.69%、59.90%)提高,差异均有统计学意义(P<0.01)。空腹血糖、糖化血红蛋白(HbA1c)、血清总胆固醇(TC)、收缩压(SBP)达标率(62.64%、58.62%、37.85%、50.00%)较入组时(55.73%、53.44%、33.33%、45.83%)提高,但差异无统计学意义(P>0.05)。低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)达标率(26.55%、29.38%)较入组时(34.74%、41.58%)下降,HDL-C差异有统计学意义(P<0.05),LDL-C差异无统计学意义(P>0.05)。30个月时达标良好率(30个月内测量总次数中达标次数≥75%)空腹血糖51.56%、餐后2 h血糖63.87%、HbA1c44.27%;血脂达标良好率TG 54.50%、TC 20.63%、LDL-C16.75%、HDL-C 21.99%;血压达标良好率SBP 22.40%、DBP 71.88%。观察期末较入组时HbA1c、SBP和DBP水平分别下降0.11%、2.2 mm Hg、3.42 mm Hg,而LDL-C增加0.04 mmol/L。观察期末三项指标联合达标率仅6.04%。结论社区老年糖尿病患者血糖、血脂及血压联合达标率较低,治疗中尤其要注重提高血脂水平的达标率。Objective To investigate the status of the joint control rate of blood glucose, blood lipid and blood pres- sure in elderly patients aged more than 60 with type 2 diabetes mellitus （T2MD） in Yongdinlu district. Methods Totally 192 pa- tients aged more than 60 and diagnosed as having T2MD were enrolled. And they were given standardized management for 30 months for observation of changes of bold glucose, blood lipid and blood pressure. Results At the end of observation the control rates of postprandial blood sugar, triglyceride （TG） and diagnostic blood pressure （DBP） were 76. 37% , 70. 06% , 78.02% , respectively, being significantly higher than those （56. 28%, 54. 69%, 59.90% ） before observation （ P 〈0. 01 ） . The rates of fasting blood - glucose （ FBG）, glycosylated hemoglobin Ale （ HbAlo ）, TC and systolic blood pressure （SBP） were 62. 64%, 58. 62% , 37.85% , 50.00% , respectively, being slightly higher than those （55.73% , 53.44% , 33.33% , 45.83% before observation, with no significant difference （ P 〉 0. 05 ） . The rates of low density lipoprotein - cholesterol （ LDL - C ） and high density lipoprotein - cholesterol （ HDL - C） were 26. 55% and 29. 38% , being lower than those （ 34. 74% , 41.58% ） before observation, but only HDL - C significantly decreased （ P 〈 0. 05 ） . After 30 - month standardized management, the optimal control rates （ the ratio of times met the requirement I〉75% ） of FBG, 2 - hour postprandial blood glucose （ 2 hPG） and HbAlo were 51.56% , 63.87% and 44. 27% ; the optimal control rates of TG, TC, LDL - C and HDL - C were 54. 50%, 20. 63% , 16. 75% a nd 21.99% ; the optimal control rates of SBP and DBP were 22.40% and 71.88%. At the end of observation the level of HbAI0 decreased by 0. 11% , the decreased readings of SBP and DBP were 2.2 mm Hg and 3.42 mm Hg, but the level of LDL - C increased by 0. 04 mmoL/L. Only 6. 04% of the patients got optimal control of their blood glucose, blood lipid and blood pressure. Concl

关 键 词：糖尿病 2型 社区管理 血糖 血脂 血压 

分 类 号：R587.1[医药卫生—内分泌]